以误吸风险评估为基础的护理模式在慢阻肺急性加重期伴呼吸衰竭机械通气患者中的应用效果

Application of Nursing Model Based on Risk Assessment of Aspiration in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Respiratory Failure by Mechanical Ventilation

目的探析以误吸风险评估为基础的护理模式在慢阻肺急性加重期伴呼吸衰竭机械通气患者中的应用效果。方法选取商丘市第一人民医院2018年5月至2022年4月收治的115例慢阻肺急性加重期伴呼吸衰竭机械通气患者作为研究对象,采用随机数表法分为观察组(57例)和对照组(58例)。对照组接受常规护理,观察组接受以误吸风险评估为基础的护理措施。两组持续护理15 d,比较两组误吸发生情况,比较护理前、护理15 d血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]以及并发症。结果观察组发生误吸3例(5.26%),对照组发生误吸12例(20.69%),差异有统计学意义(χ^(2)=6.032,P=0.014);护理15 d,两组PaO_(2)较护理前提高,PaCO_(2)较护理前降低,且观察组PaO_(2)高于对照组,PaCO_(2)低于对照组(P<0.05)。护理期间,观察组并发症发生率低于对照组(P<0.05)。结论以误吸风险评估为基础的护理模式可有效降低慢阻肺急性加重期伴呼吸衰竭机械通气患者的误吸发生风险,改善血气指标,减少并发症的发生。

Objective To explore the application effect of nursing model based on the risk of aspiration in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure by mechanical ventilation.Methods A total of 115 patients with AECOPD and respiratory failure by mechanical ventilation admitted to the First People’s Hospital of Shangqiu from May 2018 to April 2022 were selected as the research subjects.They were divided into the observation group(57 cases)and the control group(58 cases)by the random number table method.The control group received routine nursing,and the observation group received nursing measures based on the risk assessment of aspiration.After continuous nursing for 15 days,the occurrence of aspiration,blood gas analysis indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))]and complications were compared between the two groups.Results The number of cases of aspiration in the observation group was 3(5.26%),and the number of cases of aspiration in the control group was 12(20.69%),and the difference was statistically significant(χ^(2)=6.032,P=0.014).After 15 days of nursing,PaO_(2) in both groups was increased and PaCO_(2)was decreased compared with that before nursing,and PaO_(2) in the observation group was higher and PaCO_(2)was lower compared with the control group(P<0.05).During the nursing period,the incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion The nursing model based on the risk assessment of aspiration can effectively reduce the risk of aspiration in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure,improve blood gas indexes and reduce the occurrence of complications.